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BACKGROUND: In children particularly in the developing world, there is a tendency to downplay the role of primary hypertension in their health. In adults, a number of factors have clearly been associated with the incidence of hypertension. Knowledge of the prevalence of hypertension and its associated factors among children in our environment is important and could inform the need for lifestyle changes and routine blood pressure (BP) checks in children so as to reduce BP-related health risks. AIM: The aim of this study is to document the prevalence of hypertension and its risk factors among children in Enugu, Nigeria. MATERIALS AND METHODS: Children aged 6-17 years attending the outpatient clinic of a tertiary hospital, were enrolled for the study. Their socioeconomic status (SES), weight, height, BP, and dipstick urinalysis were measured using standardized methods. Adherence to Mediterranean diet was assessed using the Mediterranean Diet Quality Index (KIDMED). The prevalence of hypertension and the influence of these factors on their BP were analyzed. RESULTS: Forty-six (9%) of the 491 participants had hypertension. Of these 46 hypertensive children, 72% were females while a significantly higher proportion 57% (P = 0.006), were in the age group 13-17 years. While age, gender, and the presence of protein in urine were significantly associated with hypertension in these children; body mass index, diet, family history of hypertension, and SES were not. CONCLUSION: The prevalence of hypertension in children in this environment is high and appears to be increasing. There is need for routine BP and urinalysis check for all children in our clinics and wards.
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AIM: The aim of this study is to determine the pattern of cancer mortality (CM) seen in the University of Port Harcourt Teaching Hospital (UPTH) which is a cancer reference center in the Niger Delta Region. METHODOLOGY: This is a 6-year retrospective study of cancer-related deaths in UPTH using patients' admission registers in all the wards and emergency units. Furthermore, the death certificates of cases were reviewed. RESULTS: Three hundred and sixteen cases of cancer-related deaths occurred, involving 174 females and 142 males, in a female-to-male sex ratio of 1.2:1. All age groups were affected, with age group 40-49 years accounting for the majority (20.6%). CM was seen in all the systems, except the central nervous system. Cancers of the gastrointestinal tract and its accessory organs (liver and gall bladder) caused most mortality (27.9%), in a female-to-male ratio of 0.8:1. The single most involved organ in CM is the female breast (20.6%), distantly followed by mortality due to prostate cancers and hematolymphoid cancers which accounted for 9.2% each. Colorectal cancers accounted for 7.3% of cancer deaths and ranked 4th. Cancers of both cervix and stomach each accounted for 5.7% of mortality. The major histologic diagnoses were carcinomas (adenocarcinoma; 36.7%, invasive ductal carcinoma; 20.3%, squamous cell carcinomas; 8.2% and hepatocellular carcinomas; 4.4%). Leukemias and lymphomas accounted for 9.2% of cases, whereas sarcomas accounted for 5.1% of cases. CONCLUSION: Infection-related and noninfection-related cancers cause most mortality in UPTH. The 5th decade was the most commonly affected, while female breast was the single most involved organ. Breast, prostate and hematolymphoid malignancies are common causes of CM with death from breast occurring earliest. Majority of the deceased were educated, working-class urban dwellers. More advocacies on public acceptance of cancer screening and cancer preventive lifestyles as well as governments' improvement on workforce training and treatment infrastructure will improve the current CM profile in Port Harcourt.
RESUMO
BACKGROUND: Due to the health and economic benefits of breast milk, the World Health Organization (WHO) recommends that for infants who cannot receive breast milk from their own mothers, the next preferred option is donated breast milk. This recommendation is however rarely practiced in most developing countries where donor milk is not widely accepted. METHODS: This cross-sectional multi-center study enrolled mothers attending antenatal or pediatric clinics in six tertiary institution in south-east Nigeria using purposive and convenient sampling method. Data collection was done using pretested questionnaires. The study aimed to assess the knowledge, acceptability and willingness to donate breast milk and/or use donated breast milk for their infants It also explored factors that determine this behavior. RESULTS: A total of 1235 mothers participated; 39% (480/1225) have heard about the concept of donor milk, while only 10% (79/759) and 7% (81/1179), respectively, had adequate knowledge of the concept and policy on donor milk. Sixty percent indicated willingness to use donor milk or donate breast milk if need arises. Respondents with lower age (p = 0.049) and with higher occupational status (p = 0.001) were more likely to have adequate knowledge of donor breast milk, while respondents with lower educational attainment (p = 0.002) and those who are non-Christians (p = 0.004) were more likely to request financial inducement for donating their breast milk. Adequate knowledge of the concept of donor milk (p = 0.001), preference of donor milk to infant formula (p = 0.001) and requirement of financial remuneration (p = 0.001) were the only significant predictors of willingness to donate and/or receive donated breast milk. CONCLUSION: The knowledge of the concept of donor breast milk and awareness of policies regulating its practice in Nigeria is low, but the prospect of its acceptability is high among mothers surveyed in south-east Nigeria. Targeted public education by relevant government agencies in collaboration with clinicians, community and religious leaders about the concept of donor breast milk to families may help increase the acceptance and practice of donating breast milk and/or use of donated breast milk among mothers in the region.
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Fatalities from perinatal asphyxia remain high in developing countries, and continually assessing its risk factors will help improve outcomes in these settings. We explored how some identified risk factors predict mortality in asphyxiated newborns, to assist clinicians in prioritizing interventions. This was a 4-year prospective study conducted at the Enugu State University Teaching Hospital, Enugu, Nigeria. All newborns who met the study criteria that were admitted to this facility in this period were enrolled and monitored. Data collected were analysed with SPSS Version 18. A total of 161 newborns with perinatal asphyxia were enrolled into the study with an in-hospital incidence rate of 12.81 per 1000 birth and a case fatality rate of 18%. Overall, the APGAR scores were severe in 10%, moderate in 22%, mild to normal in 68%, whereas the SARNAT stages were III in 24%, II in 52%, and I in 25%. In terms of mortality, 66.7%, 22.2%, and 11.1% mortalities were, respectively, observed with SARNAT scores III, II, and I (P = .003), whereas the findings with APGAR were 31.2% (severe), 25.0% (moderate), 25.0% (mild), and 18.8% (normal) (P = .030). Fatality outcome was more correlated with SARNAT (R = .280; P = .000) than APGAR (R = -.247; P = .0125). The SARNAT score significantly differentiated between the degrees of asphyxia in newborns based on gestational age at delivery (P = .010), place of delivery (P = .032), and mode of delivery (P = .042). Finally, it was noted that newborns that were female (P = .007), or born outside the hospital (P = .010), or with oxygen saturations <60% (P = .001), or with heart rate <120 (P = .000), and those with respiratory rate <30 (P = .003), all have significantly higher likelihood of deaths from asphyxia. Therefore, predictors of neonatal mortality from perinatal asphyxia in our centre include being female and being born outside the hospital, as well as low oxygen saturations, heart rates, and respiratory rates at presentation.
